The Importance of Identifying Depression in Patients with Rheumatoid Arthritis

Abstract

Depression is common in patients with chronic illness including rheumatoid arthritis (RA). Identifying depression accurately and treating it appropriately are important for helping to maintain function in patients with RA. Several self-administered screening tools are available that are sensitive for the detection of depression in medical outpatients and are easy to use in a clinic setting. There has been debate regarding the validity of some of these tools for detecting depression in RA patients because of "arthritis-biased" questions. In this study, we evaluated 77 patients with RA and measured their responses to one of these screening tools, the Beck Depression Inventory (BDI). We compared disease activity and severity measures and measures of functional status between patients who were designated as depressed by BDI score and patients without depressive symptoms.We were unable to demonstrate differences in specific objective measures of disease activity, severity, or objective functional measures between nondepressed and depressed RA patients. However, depressed patients reported greater disease activity and poorer physical function, and observer global assessment of depressed patients was poorer. We conclude that the "arthritis-biased" questions in the BDI did not interfere with the detection of depression in patients with RA and should not be a deterrent for its use. We found that the BDI can be used effectively in a clinic setting as a screening tool for depression in patients with RA.